在高风险患者早期结肠癌的结合内镜和腹腔镜手术 (CELS) 中
Morten F S Hartwig1,2, Mustafa Bulut3,4,5, Jens Ravn-Eriksen3,4,5
1Department of Surgery, Center for Surgical Science, Zealand University Hospital Koege, Lykkebaekvej 1, 4600, Koege, Denmark. mofha@regionsjaelland.dk.
结合内镜和腹腔镜手术 (CELS) 是对早期结肠癌高风险患者的可行选择. 在某些情况下,这种方法可能有助于避免大肠切除.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 最少侵入性的手术
背景情况:
- 局部切除是高风险患者早期结肠癌的潜在治疗方法.
- 对这些患者来说,评估结合内镜和腹腔镜手术 (CELS) 的可行性至关重要.
研究的目的:
- 评估CELS在高风险患者早期结肠癌的可行性.
- 确定该队列中CELS的成功率和并发症概况.
主要方法:
- 进行了前性,非随机化的可行性研究.
- 包括25名高风险患者 (绩效状态≥1或ASA得分≥3) 临床第一阶段结肠癌.
- 主要结局是CELS切除失败,定义为不完全切除,复发,严重并发症或90天内死亡.
主要成果:
- 在选定的患者中,CELS切除是可行的,由于切除不完整而导致两次失败.
- 组织病理学揭示了各种瘤阶段 (pT1-pT3),没有淋巴结转移.
- 住院的中位长度为1天;七名患者需要为高风险组织学因素完成大肠切除术.
结论:
- 对于经过精心挑选的患有早期结肠癌的高风险患者来说,CELS是一种可行的手术选择.
- 这种最少的侵入性方法可能可以避免患者接受传统的大肠切除.
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